Elements and Performance Criteria

The Range of Variables explains the scope and context of the unit of competency allowing for differences between workplaces. The scope of variables chosen for training and assessment requirements will depend on the particular work situation.
Spirometer type may be a self-contained device or may be connected to a computer and may include:
· Rolling seal
· Water seal
· Bellows
· Pneumotach
· Turbine
· Hot wire
· Ultrasonic
Materials may include:
· Bronchodilator
· Delivery device
· Tubing
· Filters
· Mouthpiece
· Noseclip
Performance check must include:
· Calibration
· Quality control procedures, including use of physiological and physical standards
Patients may include:
· Children
· Adolescents
· Adults
· Elderly
· Inpatients/outpatients
Background patient information may include:
· Medical history
· Co-morbidities
· Need for use of additional precautions
· Medications, particularly bronchodilator use
· Use of bronchodilators for measurement
· Contraindications
Patient details may include:
· Name
· Medical record number
· Date of birth
· Height
· Weight
· Patient symptoms including cough, wheeze, dyspnoea
· Gender
· Ethnic background
· Workplace/ward/unit
· Requesting physician
Contraindications may include:
· Severe respiratory distress
· Physical limitations
· Cognitive impairment
· Haemoptysis of unknown origin
· Pneumothorax
· Unstable cardiovascular status eg recent myocardial infarction
· Acute thoracic, abdominal, or cerebral aneurysmata
· Recent eye surgery
· Acute disorders affecting test performance eg vomiting, nausea or fainting
· Recent thoracic or abdominal surgical procedures
Additional information may include:
· Room temperature
· Barometric pressure
· Humidity
Technically correct must include:
· No hesitation at start ie extrapolated volume within standards
· Evidence of maximal effort ie existing standards regarding time to PEF, reproducibility
· No cough within first second
· End of test criteria achieved
· Reproducibility of FEV1, FVC & PEF,
Current standards include:
· Thoracic Society of Australia and New Zealand (TSANZ)
· Australia and New Zealand Society of Respiratory Scientists (ANZSRS)
· American Thoracic Society (ATS)
· European Respiratory Society (ERS)
Clinical emergencies may include:
· Severe respiratory distress
· Cardio-respiratory arrest
Authorised person may include:
· people authorised to administer bronchodilator according to relevant state/territory legislation relating to the administration of medication

The Evidence Guide identifies the critical aspects of assessment, and the essential knowledge and skills to be demonstrated to confirm competency in this unit. The Evidence Guide is an integral part of the assessment of competency and it should be read carefully in conjunction with the Range of Variables, elements and performance criteria.
Critical aspects of assessment must include:
· Complies with policies and procedures including those of OHS and infection control
· Demonstrates ability to produce a spirometry measurement which accurately reflects the maximal expiratory ventilatory capacity of the patient
· Identify and respond to technical errors in recording
· Identify and respond to contraindications before and during test
· Demonstrate an ability to communicate effectively with patients/carers in relation to the procedure and manage patients'/carers' anxiety level
· Identify steps that must be taken to ensure equipment and environment is safe
· Knowledge of boundaries of responsibilities and ability to refer problems to supervisor or other appropriate health professional
Concurrent assessment and relationship with other units:
· This unit can be assessed independently, however holistic assessment practice with other health services units of competency is encouraged
Essential knowledge must include:
· Anatomy and physiology relevant for spirometry measurement
· Basic pharmacology related to respiratory function relevant for spirometry measurement
· Purpose of spirometry measurement
· Basic maths & statistics relevant for spirometry measurement
· Recognition of patterns of normal/abnormal results related to both respiratory disease and technical factors relevant for spirometry measurement
· Complications and contraindications for patients undergoing spirometry measurement
· Emergency procedures in the event of a clinical emergency relevant in the performance of a spirometry
· Protocols for spirometry measurement and conformance to standards
· Principles and validation techniques of spirometry
· Use of reference values relevant for spirometry measurement
· Relevance of environmental factors eg temperature, humidity
· Conversion of volumes from atmospheric temperature and pressure (ATP) to body temperature and pressure saturated (BTPS)
· Instrument quality control
· Respiratory therapy products eg nebulisers, inhalers, spacers
· Routine maintenance policy and procedures for equipment
· Common causes of patient non compliance and the appropriate remedies
· Confidentiality requirements of patient information
Essential skills must include:
· Ability to communicate with patient to elicit maximum co-operation to produce optimal results
· Correct assembly and operation of equipment
· Basic computer skills relevant to spirometry measurement
· Recognition of errors due to patient performance and technical faults
· Ability to recognise malfunction in respiratory therapy products
· Basic cardiopulmonary resuscitation
· Reading and writing skills-literacy competence required to fulfil job roles in a safe manner and as specified by the organisation. The level of skill required involves reading and documenting clinical information and understanding procedure manuals.
· Oral communication skills-language competence required to fulfil job roles in a safe manner and as specified by the organisation. Assessors should look for skills in asking questions, providing clear information, listening to and understanding workplace instructions, and clarifying workplace instructions when necessary. Effective verbal and non verbal communication skills with a range of internal and external persons are essential. Organisation may require competence in English or a community language, depending on client group
· Numeracy skills ranges from the ability to complete basic arithmetic calculations, recording stock levels and statistical information
· Problem solving skills required include an ability to use available resources
· Ability to deal with conflict
· Ability to work with others and display empathy with patient and relatives
Resource implications:
· Access to appropriate workplace where assessment can take place
· Relevant organisational policy, guidelines, procedures and protocols
Method of assessment:
· Observation of work activities
· Written tasks
· Relevant formal and informal education/training courses
· Case studies and scenarios
· Interviews/Questioning
· Log of assessment with tasks and milestones
· Portfolio of tests performed
Consistency in performance:
It is recommended that assessment or information for assessment will be conducted or gathered over a period of time and cover the normal range of workplace situations
Context of assessment:
This unit will be most appropriately assessed in the workplace or in a simulated workplace and under the normal range of workplace conditions